Endotracheal Tube and Laryngeal Mask Airway
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This document discusses endotracheal tubes and laryngeal mask airways. It begins by describing what endotracheal tubes are and their uses in intubation to protect the airway and enable mechanical ventilation. It covers tube types, sizing, intubation procedure, and complications. It then describes laryngeal mask airways as an alternative to intubation for maintaining the airway during anesthesia, noting they are easier to insert but do not provide the same protection from aspiration.
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- It has a rapid onset and context-sensitive half-life, distributing quickly throughout the body before being metabolized in the liver.
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Capnography
This document provides an overview of capnography including:
1) The objectives of describing ventilation, perfusion, and their relationship as assessed by capnography.
2) A description of the normal capnogram waveform and factors that can cause abnormal waveforms related to airway, breathing, and circulation problems.
3) Clinical applications of capnography including confirming endotracheal tube placement, assessing ventilation status, and predicting outcomes of cardiac arrest resuscitation.
ENDOTRACHEAL TUBE INTUBATION II Parts II Details II Clinical Discussion
What is endotracheal intubation?
Endotracheal intubation is a procedure by which a tube is inserted through the mouth down into the trachea (the large airway from the mouth to the lungs). Before surgery, this is often done under deep sedation. In emergency situations, the patient is often unconscious at the time of this procedure.
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The document discusses surgical airways, including a brief history, relevant anatomy, classifications, indications, techniques, and complications. Surgical airways such as tracheostomy and cricothyrotomy are performed when intubation is impossible or contraindicated to bypass upper airway obstruction and provide long-term ventilation. Complications include bleeding, infection, and stenosis if not performed properly. Tracheostomy involves making an opening in the trachea while cricothyrotomy is through the cricothyroid membrane as a temporary measure until a definitive airway is established.
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Basics of airway management april 2018
1) The document discusses the basics of airway management in pediatrics, including anatomy, developmental considerations, signs of impending respiratory failure, and methods of assessing and establishing an airway.
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The document discusses tracheostomy emergencies, including indications for tracheostomies, different types of tracheostomy tubes, and approaches to emergencies such as tube obstruction or displacement. Case studies are presented on blocked and dislodged tracheostomy tubes. Key steps in managing emergencies include providing oxygen, suctioning, changing to a cuffed tube if needed, and ensuring correct tube placement. Understanding tracheostomy emergencies is important for emergency nurses as more patients are discharged home with long-term tracheostomies.
APIL Conference 2012
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Endotracheal intubation &; its complications
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
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ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
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Olfactory Genes:
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Olfactory Membrane:
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Endotracheal Tube and Laryngeal Mask Airway
- 2. Endotracheal Tube By Isuru Tilakaratna
- 3. Questions • What is this? • What are the indications? • Procedure of Endotracheal Intubation • What are the complications?
- 4. Anatomy of ET tube
- 7. What is this? Magill’s Forcep
- 8. Magill’s Forcep • Designed for guiding tip of ETT through larynx during nasal intubation • Insertion of nasogastric tubes • Removal of forign bodies • Putting pharyngeal packs
- 10. Types of ET Tubes • Non cuffed – In the pediatric population, the cricoid ring is sufficiently narrow to form a seal all by itself – cricoid ring is ellipsoid rather than circular • Cuffed – In the adults, the trachea is considerably wider – The cuff helps to • seal the trachea, so that positive pressure cannot escape from the lower airway • seal the upper airway, so that material above the glottis cannot enter the trachea
- 11. Types of ET Tubes
- 12. ET Tube materials • polyvinyl chloride (PVC ) – Widely available • Polyethylene (portex type) • Silicon rubber latex • Red rubber (magill variety)
- 13. Indications • Indications for intubation – To overcome an airway obstruction and protect the airway – To allow access to the lower airway for suctioning of secretions – To allow mechanical ventilation in a patient in whom non-invasive ventilation is contraindicated – Administration other gases or volatile anesthetic – Administration certain medication such as salbutamol,atropine
- 14. Indications • Indications for mechanical ventilation – To manipulate PaO2 and PaCO2 – To decrease the work of breathing – To increase the functional residual capacity (FRC) – To stabilize the chest wall in serious chest injuries
- 15. Contraindications • Contraindications for intubation – Absence of upper airway (eg. radical laryngectomy) – Laryngeal trauma which would be exacerbated by ETT insertion (eg. fractured larynx) – Transection of the airway which could be exacerbated by ETT insertion
- 16. If ET intubation contraindicated, what is the next considerable option? • Tracheostomy
- 17. ET Intubation • Procedure – Size selection ( internal diameter) • For children over the one year – Size of ETT = Age in years/4 + 4.5mm • Size charts • Children younger than one year, the size of ET tube roughly equal to their diameter of little finger • Adult males 7.5-8 • Adult female 7-7.5
- 24. Complications • Immediate complications – Failure of intubation – Oesophageal intubation – Dislodgement above the glottis (tube falling out) – Endobronchial intubation (tube falling in) – Cuff rupture, pressure loss – Trauma due to intubation (eg. tracheobronchial injury, even perforation)
- 25. Complications • Early complications – Obstruction of the tube (be it kinked by teeth or clogged with phlegm) • Late complications – Laryngeal oedema – Mucosal ulceration and necrosis from prolonged intubation
- 26. What is this?
- 27. Laryngeal Mask Airway By Isuru Tilakaratna
- 29. LMA • A device to maintain airway during anesthesia when TI is not desired • It’s easier in insertion and has high rate of success • Can use for short procedures • It’s made in various sizes to suite neonates, children and adults
- 30. Indications – To overcome an airway obstruction and protect the airway – To allow mechanical ventilation in a patient in whom non-invasive ventilation is not successful – Administration other gases or volatile anesthetic – Administration certain medication such as salbutamol,atropine
- 31. Contraindications • Increased risk of aspiration • Full stomach
- 32. Size selection • 1 under 5 kg • 1.5 5 – 10kg • 2 10 – 20kg • 2.5 20 – 30kg • 3 30 kg / Small adults • 4 Adults • 5 Large adults / poor seal with size 4
- 33. Procedure • Size selection • Examination of the LMA – Cuff for tears and Inflate/ Deflate to check the functioning and leakages – Tube for blockages and loose particles • Lubrication – Lubricate the back of the mask thoroughly – Avoid excessive amount lubricant on anterior surface because inhalation can cause cough and obstructions
- 34. Procedure • Pre oxigenation • Better inserted with propofol (that depresses laryngeal reflex) or deep inhalation anesthesia • After adequate anesthesia, LMA is inserted to mouth blindly without laryngoscope and pushed downward till resistance is felt. The cuff is then inflated
- 35. Complications • Use of LMA avoids occurrence of most ETI complication • Lack of mechanical protection from regurgitation and aspiration • Laryngospasm • Coughing • Sore throat